Controlling PI resistance like a switch: MDR1 and p-glycoprotein

One specific gene in a person’s body could literally be a drug-resistance switch — it may turn on and off a person’s ability to develop resistance to some protease inhibitors. GMHC Treatment Issues reports.

It’s well understood that unwavering adherence to one’s antiretroviral therapy (ART) regimen gives the best chance of keeping drug levels high enough to sustain suppression of viral replication and allow immune recovery to take root. Yet perfect performance is not a sure bet. Some people who never miss a dose fail to see their T-cells rise — even though their viral load stays within moderate levels. Others have all the luck: their virus goes undetectable and stays there for years while their CD4 counts hover near quadruple digits — all with side effects no more serious than occasional diarrhoea. Many clinicians have long thought that some genetic advantage must be at work, but there’s been little proof and no way to tell who’s drawn the lucky DNA.

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